Exploring Potential Drug-Drug Interactions: A Cross-Sectional Study of 1 Million e-Prescriptions Across Medical Specialties in Shiraz, Iran (2021-2024).

Background: Drug-drug interactions (DDIs) are among the most important medical errors that can lead to adverse effects, increased toxicity, or reduced treatment efficacy. The frequency and severity of DDIs vary across specialties. However, studies covering multiple specialties in Iran are few and no...

Full description

Bibliographic Details
Published in:Iranian Journal of Medical Sciences Vol. 51; no. 2; pp. 104 - 118
Main Authors: Porbaha, Pedram, Hasannejad, Mohammad, Ahvar, Negar, Shafiekhani, Mojtaba, Abolpour, Nahid, Sharifi, Mehrdad
Format: research tables/charts Journal Article
Published: Shiraz University of Medical Sciences Feb2026
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191787150&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 191787150
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        02530716
        8TQH
      jtl: Iranian Journal of Medical Sciences
      issn: 02530716
      maglogo: N
    pubinfo:
      dt: Feb2026
      vid: 51
      iid: 2
      pid: 65846
      pub: Shiraz University of Medical Sciences
      place: Shiraz, <Blank>
    artinfo:
      ui:
        191787150
        191787150
        191787150
        10.30476/ijms.2025.106551.4081
        191787150
      ppf: 104
      ppct: 14
      formats:
      tig:
        atl: Exploring Potential Drug-Drug Interactions: A Cross-Sectional Study of 1 Million e-Prescriptions Across Medical Specialties in Shiraz, Iran (2021-2024).
      aug:
        au:
          Porbaha, Pedram
          Hasannejad, Mohammad
          Ahvar, Negar
          Shafiekhani, Mojtaba
          Abolpour, Nahid
          Sharifi, Mehrdad
        affil: Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
      sug:
        subj:
          Drug Interactions Evaluation
          Prescriptions, Drug
          Specialties, Medical Iran
          Prescribing Patterns
          Electronic Order Entry
          Human
          Iran
          Cross Sectional Studies
          Record Review
          Prevalence
          Software
          Programming Languages
          Dexamethasone
          Ketorolac
          Quetiapine
          Aspirin
          Naproxen
          Doxorubicin
          Prednisolone
          Tacrolimus
          Diclofenac
          Rheumatology
          Endocrinology
          Orthopedics
          Oncology
          Internal Medicine
          Emergency Service
          Psychiatry
      ab: Background: Drug-drug interactions (DDIs) are among the most important medical errors that can lead to adverse effects, increased toxicity, or reduced treatment efficacy. The frequency and severity of DDIs vary across specialties. However, studies covering multiple specialties in Iran are few and not up-to-date. This study aims to fill this gap by offering a large-scale, multi-specialty analysis of DDIs in Iran using real-world e-prescription data. Methods: This study analyzed pharmacological DDIs in 1,049,769 e-prescription records from Shiraz, Iran, spanning from November 2021 to February 2024. We used Lexicomp® DDI checker software and Python programming language to identify the most prevalent DDIs overall, the top contributing drug specialties for each of those DDIs, the specialties with the highest rates of potential DDIs, and the most prevalent DDI within each specialty. Results: The analysis revealed that 38.77% of prescriptions contained at least one C, D, or X DDI. Dexamethasone, ketorolac, quetiapine, and aspirin were the drugs most commonly involved. The most frequent DDIs occurred between aprepitant and dexamethasone, ketorolac, and naproxen, aprepitant and doxorubicin, prednisolone, and tacrolimus, and diclofenac sodium and ketorolac. The medical specialties with the highest incidence of D or X level DDIs were rheumatology, endocrinology, orthopedics, oncology, internal medicine, emergency services, and psychiatry. The average counts of D or X DDIs per prescription were 0.53, 0.41, 0.40, 0.40, 0.26, 0.24, and 0.23, respectively. Conclusion: This study underscores the need for provider vigilance and proactive measures, such as training and e-prescription alerts, to ensure patient safety.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N